Are Adenomyosis and Endometriosis the Same Disease?
Release Date: 09/15/2025
Hysterectomy & Endometriosis: Myths, Realities, and When It Actually Helps
The Endometriosis Podcast
In this episode of The Endometriosis Podcast, Dr. Nicholas Fogelson and Dr. Shanti Mohling take on one of the most emotionally charged and misunderstood topics in pelvic pain care: hysterectomy. Drawing on decades of surgical experience, they unpack common myths, clarify confusing terminology, and explain when hysterectomy may—or may not—be an appropriate part of endometriosis treatment. This thoughtful, nuanced conversation emphasizes individualized care, informed consent, and the importance of excision surgery alongside any uterine decision Highlights: Why hysterectomy does not...
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Beyond Estrogen Myths: Rethinking Hormone Therapy and Endometriosis
The Endometriosis Podcast
In this episode, Dr. Nick Fogelson and Dr. Shanti Mohling take on one of the most persistent gray zones in gynecology: how to safely use hormone replacement therapy in patients with current or past endometriosis. Moving beyond the simplistic “estrogen bad” narrative, they explore what the data actually show about recurrence, cancer risk, and quality of life. The discussion weaves clinical insight with case studies, examining how progesterone’s protective role, surgical completeness, and individualized dosing all shape outcomes. Highlights: The lingering misconceptions from the Women’s...
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Are Adenomyosis and Endometriosis the Same Disease?
The Endometriosis Podcast
In this thought-provoking episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling delve into new research that challenges how we understand adenomyosis in relation to endometriosis. They break down the proposed subtypes of adenomyosis— from interna and externa to intramural and adenomyomas— and discuss how these patterns may arise from childbirth, uterine surgery, or molecular changes shared with endometriosis. Along the way, they revisit century-old theories, weigh the evidence for different pathways of disease development, and explore what this means for treatment decisions, fertility...
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Functional Medicine and Endometriosis: What the Research Really Says
The Endometriosis Podcast
In this illuminating episode, Dr. Shanti Mohling and Dr. Nicholas Fogelson dive into the science behind supplements and functional medicine approaches to managing endometriosis. From NAC and curcumin to the role of Vitamin D and the gut microbiome, they explore which anti-inflammatory tools hold real promise—and which ones may not. They also tackle a listener's question about persistent post-op symptoms and break down why the term “IBS” isn’t always the end of the diagnostic road. Highlights: The anti-inflammatory mechanisms of NAC, alpha-lipoic acid, curcumin, and fish oil Why...
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Endometriosis and Sciatica: Pioneering Research on Nerve Entrapment, Vascular Compression, and Surgical Solutions
The Endometriosis Podcast
In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling dive deep into the complex overlap between endometriosis and nerve-related pelvic pain. They discuss a pivotal paper by Dr. Marc Possover on laparoscopic treatment for endometriosis and vascular entrapment of the sacral plexus — groundbreaking work that opened new paths for addressing sciatica caused by pelvic disease. The conversation explores how nerve irritation and compression can manifest, why menstrual cycle patterns matter, and how careful patient selection guides surgical decisions. If you or someone you know has...
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Spontaneous Conception After Endometriosis Surgery: What the Research Shows
The Endometriosis Podcast
In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling discuss a compelling new study from the Journal of Minimally Invasive Gynecology exploring spontaneous conception and live birth rates in infertility patients after endometriosis surgery. They break down what the data reveals about excision versus ablation, the role of age, and the surprising lack of correlation between disease stage and fertility outcomes. Along the way, they examine how inflammation impacts egg viability, why BMI may not matter as much as once believed, and how social media is transforming surgical education and...
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Episode 5: Bowel Surgery for Endometriosis: Conservative vs. Radical Approaches
The Endometriosis Podcast
In this episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling relaunch The Endometriosis Podcast with an in-depth look at one of the most crucial surgical decisions for patients with deep endometriosis: how aggressive should bowel surgery be? You’ll hear their thoughts on recent meta-analysis comparing conservative techniques (like shave and discoid resection) to radical approaches (like segmental bowel resection). Dr. Fogelson and Dr. Mohling break down how disease severity, nerve preservation, and surgical judgment all shape patient outcomes — and why sometimes a more radical surgery is...
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Episode 4: Robotic Surgery vs. Excision, Medical Treatment Post Excision, Endometriomas and Fertility
The Endometriosis Podcast
Join surgeon Nicholas Fogelson and endometriosis researcher Libby Hopton as they answer listener questions and discuss recently published research. This episode was recorded in July 2017. Stay tuned for future episodes!
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Episode 3: Ablation vs. excision for superficial endo, hormonal contraceptives, the "Endobiota" and more
The Endometriosis Podcast
Dr. Nicholas Fogelson, MD, and Libby Hopton discuss new literature on endometriosis. Studies include a comparison of excision and ablation surgeries for superficial endometriosis, and a review of studies on treating the disease with hormonal contraception. Also, a look at how endometriosis may be connected to the state of a patient's microbiome, and more.
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Episode 2: Removing abdominal wall endo after c-section, Visanne, surgery center vs. hospital and more
The Endometriosis Podcast
Dr. Nicholas Fogelson, MD, and Libby Hopton discuss new literature on endometriosis and answer questions from the endometriosis patient community. Topics include removing abdominal wall endo after c-section, Visanne studies, whether to chose a surgery center or a hospital and more.
info_outlineIn this thought-provoking episode, Dr. Nicholas Fogelson and Dr. Shanti Mohling delve into new research that challenges how we understand adenomyosis in relation to endometriosis. They break down the proposed subtypes of adenomyosis— from interna and externa to intramural and adenomyomas— and discuss how these patterns may arise from childbirth, uterine surgery, or molecular changes shared with endometriosis. Along the way, they revisit century-old theories, weigh the evidence for different pathways of disease development, and explore what this means for treatment decisions, fertility preservation, and patient pain.
Highlights:
- Defining adenomyosis and how it differs from—and overlaps with—endometriosis
- Subtypes of adenomyosis: interna, externa, intramural, and adenomyomas
- Theories of origin: tissue injury and repair, retrograde menstruation, embryonic remnants, and genetic mutations
- Why hysterectomy can sometimes relieve pain when conservative surgery cannot
- Understanding why patients with minimal disease may have severe pain while others with advanced disease experience little or none
For clinical consultations: contact Northwest Endometriosis and Pelvic Surgery in Portland, OR at (503) 715-1377 or email us at newpatients@nwendometriosis.com
Follow us on Instagram: @Nicholasfogelson and @drshantimohling
Download a transcript of this episode.